• NettoIrene de PedroIde PHead and Neck Surgery and Otorhinolaryngology Department, Hospital do Câncer A. C. Camargo, São Paulo, Brazil., Jose Guilherme Vartanian, Pablo Rodrigo Rocha Ferraz, Priscila Salgado, Juliana Bueno Meirelles de Azevedo, Ronaldo Nunes Toledo, José Ricardo Gurgel Testa, Elisabete Carrara-de-Angelis, and Luiz Paulo Kowalski.
• Head and Neck Surgery and Otorhinolaryngology Department, Hospital do Câncer A. C. Camargo, São Paulo, Brazil.
• Sao Paulo Med J. 2007 May 3; 125 (3): 186190186-90.

Context And ObjectiveIntraoperative nerve monitoring has emerged as a valuable tool to facilitate recurrent laryngeal nerve identification during thyroid surgery, thereby avoiding its injury. The aim was to evaluate vocal fold mobility in patients who underwent thyroidectomy with intraoperative nerve monitoring.Design And SettingCohort formed by a consecutive series of patients, at a tertiary cancer hospital.MethodsThe subjects were patients who underwent thyroidectomy using intraoperative laryngeal nerve monitoring, between November 2003 and January 2006. Descriptive analysis of the results and comparison with a similar group of patients who did not undergo nerve monitoring were performed.ResultsA total of 104 patients were studied. Total thyroidectomy was performed on 65 patients. Vocal fold immobility (total or partial) was detected in 12 patients (6.8% of the nerves at risk) at the first postoperative evaluation. Only six (3.4% of the nerves at risk) continued to present vocal fold immobility three months after surgery. Our previous series with 100 similar patients without intraoperative nerve monitoring revealed that 12 patients (7.5%) presented vocal fold immobility at the early examination, and just 5 (3.1%) maintained this immobility three months after surgery, without significant difference between the two series.ConclusionIn this series, the use of intraoperative nerve monitoring did not decrease the rate of vocal fold immobility.

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